Materiały źródłowe

• #1 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. […] Treatment should be cause-specific. There are many approaches to treatment planning, including various psychological interventions, pharmacotherapy, and specific treatments for infertile men. […] A number of approaches can be employed for infertile men, including the collection of nocturnal emissions, prostatic massage, prostatic urethra catheterization, penile vibratory stimulation, probe electroejaculation, sperm retrieval by aspiration from either the vas deferens or the epididymis, and testicular sperm extraction. […] There is currently no single gold standard for diagnosing DE/AE, as operationalized criteria do not exist.

• #2 Treatment of Delayed Ejaculation in Males | Counseling

  https://counselingcenterforsexualhealth.com/sex-therapy/treatment-of-delay-ejaculation-in-males/

  Current DSM 5 Diagnosis called Delayed Ejaculation […] Delayed ejaculation or impaired ejaculation is a common medical diagnosis that requires you have a delayed ejaculation or absence of ejaculation during almost all or all (approximately 75 100%) of partnered sexual activity without the individual desiring delay; symptoms must have a minimum duration of about six months. […] While delayed ejaculation does not present any serious health risks, it does cause much stress amongst patients. Furthermore, it can lead to many problems in a persons relationship that has the potential to create relational distress. […] Both psychological and physical issues can cause delays in ejaculation; however, psychological factors are the most common reason why men develop this condition. […] The most common psychological factors that might cause delayed ejaculation in men are the following; Anxiety, Depression, Childhood issues (such as trauma, neglect, unexpressed anger and behavioral issues, bonding difficulties, negative or suppressed sexual upbringing), Attitude issues such as a loss of confidence, negative body image, or performance anxiety, Religious beliefs that label sexual activity for pleasure or for any other reason other than for reproduction as a sin, Fear of ejaculation, female genitalia, pregnancy, or an inexplicit fear of defiling and hurting ones partner through coitus or ejaculation.

• #3 Delayed ejaculation: Causes, treatment, and outlook

  https://www.medicalnewstoday.com/articles/284679

  Delayed ejaculation refers to a difficulty or inability of a male to reach an orgasm and ejaculate semen. Both physical and psychological issues can cause someone to be unable to climax. […] Delayed ejaculation affects around 14% of the male population. […] Most men will experience delayed ejaculation at some point in their lives, but for some, it is a lifelong problem. […] Delayed ejaculation can have a psychological or biological cause. There can also be an overlap between the two. It can be a lifelong condition, where a person has always had difficulty reaching an orgasm. […] However, more commonly, delayed ejaculation occurs after a period of typical function. […] An acquired case is usually determined as having a psychological cause if it only happens in specific situations.

• #4 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  The following can increase the risk of having delayed ejaculation: Older age. With aging, ejaculation takes longer. Psychological conditions, such as depression or anxiety. Medical conditions, such as diabetes or multiple sclerosis. Certain medical treatments, such as prostate surgery. Medicines, such as certain antidepressants, high blood pressure medicines or water pills, called diuretics. Relationship problems, such as not being able to talk to your partner. Excessive alcohol use, especially long-term heavy drinking. […] Complications of delayed ejaculation can include: Less sexual pleasure for you and your partner. Stress or anxiety about having sex. Marital or relationship problems due to a poor sex life. Not being able to get your partner pregnant, called infertility.

• #5 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation can have psychological or physical causes. […] Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. Realize that you cannot force yourself to have a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder you try to have a certain sexual response, the harder it may become to respond. […] To reduce the pressure, focus on the pleasure of the moment. Do not worry about whether or when you will ejaculate. Your partner can help by creating a relaxed atmosphere, and by not pressuring you about whether or not you have ejaculated. Openly discuss any fears or anxieties, such as fear of pregnancy or disease, with your partner.

• #6 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] Can delayed ejaculation be prevented? […] Delayed ejaculation can’t be prevented if the cause is physical, such as nerve damage. But you can avoid things that might make delayed ejaculation worse, such as alcohol and recreational drugs.

• #7 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  The following can increase the risk of having delayed ejaculation: Older age. With aging, ejaculation takes longer. Psychological conditions, such as depression or anxiety. Medical conditions, such as diabetes or multiple sclerosis. Certain medical treatments, such as prostate surgery. Medicines, such as certain antidepressants, high blood pressure medicines or water pills, called diuretics. Relationship problems, such as not being able to talk to your partner. Excessive alcohol use, especially long-term heavy drinking. […] Complications of delayed ejaculation can include: Less sexual pleasure for you and your partner. Stress or anxiety about having sex. Marital or relationship problems due to a poor sex life. Not being able to get your partner pregnant, called infertility.

• #8 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression. […] Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis.

• #9 Delayed ejaculation Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/delayed-ejaculation

  Delayed ejaculation is a medical condition in which a male cannot ejaculate easily or at all. […] Delayed ejaculation can have psychological or physical causes. […] If you have never ejaculated through any form of stimulation, see your health care provider to determine if the problem has a physical cause. […] See a therapist who specializes in ejaculation problems if you are unable to ejaculate in an acceptable amount of time. […] Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. […] To reduce the pressure, focus on the pleasure of the moment. Do not worry about whether or when you will ejaculate. Your partner can help by creating a relaxed atmosphere, and by not pressuring you about whether or not you have ejaculated.

• #10 Delayed ejaculation – UF Health

  https://ufhealth.org/conditions-and-treatments/delayed-ejaculation

  Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. […] Realize that you cannot force yourself to have a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder you try to have a certain sexual response, the harder it becomes to respond. […] To reduce the pressure, focus on the pleasure of the moment. Do not worry about whether or when you will ejaculate. Your partner should create a relaxed atmosphere, and should not pressure you about whether or not you have ejaculated. Openly discuss any fears or anxieties, such as fear of pregnancy or disease, with your partner.

• #11 Delayed ejaculation: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001954.htm

  Delayed ejaculation can have psychological or physical causes. […] Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. Realize that you cannot force yourself to have a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder you try to have a certain sexual response, the harder it may become to respond. […] To reduce the pressure, focus on the pleasure of the moment. Do not worry about whether or when you will ejaculate. Your partner can help by creating a relaxed atmosphere, and by not pressuring you about whether or not you have ejaculated. Openly discuss any fears or anxieties, such as fear of pregnancy or disease, with your partner.

• #12 Delayed ejaculation – UF Health

  https://ufhealth.org/conditions-and-treatments/delayed-ejaculation

  Having a healthy attitude about your sexuality and genitals helps prevent delayed ejaculation. […] Realize that you cannot force yourself to have a sexual response, just as you cannot force yourself to go to sleep or to perspire. The harder you try to have a certain sexual response, the harder it becomes to respond. […] To reduce the pressure, focus on the pleasure of the moment. Do not worry about whether or when you will ejaculate. Your partner should create a relaxed atmosphere, and should not pressure you about whether or not you have ejaculated. Openly discuss any fears or anxieties, such as fear of pregnancy or disease, with your partner.

• #13 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] Can delayed ejaculation be prevented? […] Delayed ejaculation can’t be prevented if the cause is physical, such as nerve damage. But you can avoid things that might make delayed ejaculation worse, such as alcohol and recreational drugs.

• #14 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can be prevented. […] Drinking alcohol in moderation can help reduce your chances of having delayed ejaculation. […] It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

• #15 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] Can delayed ejaculation be prevented? […] Delayed ejaculation can’t be prevented if the cause is physical, such as nerve damage. But you can avoid things that might make delayed ejaculation worse, such as alcohol and recreational drugs.

• #16 Treatment of Delayed Ejaculation in Males | Counseling

  https://counselingcenterforsexualhealth.com/sex-therapy/treatment-of-delay-ejaculation-in-males/

  There are a number of physical factors, along with other issues as well that might lead to delayed ejaculation. […] The four main types of treatments that can cure delayed ejaculation, both individually or in combination, as per the diagnosis are: Urological treatments for birth defects or pelvic injuries, Counseling for psychological factors, Medication, Alternative treatments. […] Alternative treatments for delayed ejaculation are uncommon, yet they can be made use of, such as moving towards a healthier lifestyle and diet. While a healthy diet and lifestyle might not directly cure the issue of delayed ejaculation, it can be used to control factors that cause or aggravate the issue such as heart disease.

• #17 Premature Ejaculation (PE): Causes, Symptoms, Prevention and Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/understanding-premature-ejaculation-causes-treatment-prevention

  How to prevent early ejaculation can be a very daunting question in your mind. But the good news is premature ejaculation can be delayed. Here are some tips for you: […] Incorporate pelvic floor exercises in your daily routine to strengthen your pelvic muscles and have better control of ejaculation. Identify the muscle you would use to stop urinating midstream, then squeeze and release. Begin with a few seconds, increasing gradually. Aim for 10 contractions. […] Maintain a stress-free lifestyle to prevent early ejaculation. […] If external help is required, reach out to a psychological counsellor and a urologist; together, they can help rectify your issues.

• #18 Treatment of Delayed Ejaculation in Males | Counseling

  https://counselingcenterforsexualhealth.com/sex-therapy/treatment-of-delay-ejaculation-in-males/

  There are a number of physical factors, along with other issues as well that might lead to delayed ejaculation. […] The four main types of treatments that can cure delayed ejaculation, both individually or in combination, as per the diagnosis are: Urological treatments for birth defects or pelvic injuries, Counseling for psychological factors, Medication, Alternative treatments. […] Alternative treatments for delayed ejaculation are uncommon, yet they can be made use of, such as moving towards a healthier lifestyle and diet. While a healthy diet and lifestyle might not directly cure the issue of delayed ejaculation, it can be used to control factors that cause or aggravate the issue such as heart disease.

• #19 Techniques and Exercises on Delaying Ejaculation Naturally

  https://holmenshealth.com.au/blog/ejaculation-naturally/

  In this blog, we’ll explore how various natural approaches such as Behavioural Therapy and Kegel Exercises, like Pelvic Floor Exercises, can potentially alleviate the symptoms and intensity of premature ejaculation, resulting in a delayed response to ejaculation. […] Various behavioural therapies could be considered to enhance tolerance and prolong ejaculation. Essentially, these therapies involve training the patient to identify when ejaculation is about to occur and then teaching them, through habituation and practice, how to postpone ejaculation. […] The pelvic floor muscles regulate the passage of urine or bodily fluids secreted by our penis via the urethra. As we age, the pelvic muscles tend to weaken. The aim of these exercises is to develop the ability to voluntarily contract these muscles.

• #20 Premature Ejaculation (PE): Causes, Symptoms, Prevention and Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/understanding-premature-ejaculation-causes-treatment-prevention

  How to prevent early ejaculation can be a very daunting question in your mind. But the good news is premature ejaculation can be delayed. Here are some tips for you: […] Incorporate pelvic floor exercises in your daily routine to strengthen your pelvic muscles and have better control of ejaculation. Identify the muscle you would use to stop urinating midstream, then squeeze and release. Begin with a few seconds, increasing gradually. Aim for 10 contractions. […] Maintain a stress-free lifestyle to prevent early ejaculation. […] If external help is required, reach out to a psychological counsellor and a urologist; together, they can help rectify your issues.

• #21 Premature Ejaculation Exercises: Proven Activities to Delay Ejaculation – Premier Men’s Medical

  https://premiermensmedical.com/blog/premature-ejaculation-exercises/

  Just like erectile dysfunction, premature ejaculation (PE) can severely affect your sexual health. But there’s good news: If you do premature ejaculation exercises to delay ejaculation regularly, you’ll have better control during intercourse. […] Here now are some exercises for delayed ejaculation. While these ejaculatory control exercises and techniques aren’t lifelong treatments, they may help to delay orgasm so that you and your partner can make love multiple times a day for longer. […] Doing a kegel exercise for premature ejaculation will help strengthen the ischiocavernosus and bulbocavernosus muscles which are located in the pelvic floor muscle area. These are found around the penis and are active when it becomes aroused. […] Regularly doing these exercises will help delay ejaculation.

• #22 Techniques and Exercises on Delaying Ejaculation Naturally

  https://holmenshealth.com.au/blog/ejaculation-naturally/

  In this blog, we’ll explore how various natural approaches such as Behavioural Therapy and Kegel Exercises, like Pelvic Floor Exercises, can potentially alleviate the symptoms and intensity of premature ejaculation, resulting in a delayed response to ejaculation. […] Various behavioural therapies could be considered to enhance tolerance and prolong ejaculation. Essentially, these therapies involve training the patient to identify when ejaculation is about to occur and then teaching them, through habituation and practice, how to postpone ejaculation. […] The pelvic floor muscles regulate the passage of urine or bodily fluids secreted by our penis via the urethra. As we age, the pelvic muscles tend to weaken. The aim of these exercises is to develop the ability to voluntarily contract these muscles.

• #23 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  Traditional behavioral sex therapy for delayed ejaculation is as follows: the man begins by masturbating, then starts intercourse when he is almost ready to ejaculate; the procedure continues with the man beginning intercourse earlier and earlier. […] Delayed ejaculation carries with it issues of inability to achieve orgasm and infertility. Anti-depressants or agents which act centrally such as Valium, anti-hypertensives and alcohol abuse all can affect this. […] A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. If the delayed ejaculation is situational is is probably psychologic; if it is generalized the problem is probably biologic.

• #24 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can be prevented. […] Drinking alcohol in moderation can help reduce your chances of having delayed ejaculation. […] It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

• #25 Delayed ejaculation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/diagnosis-treatment/drc-20371363

  A physical exam and medical history might be all that are needed to suggest treatment for delayed ejaculation. […] Delayed ejaculation treatment depends on the cause. Treatment might include taking medicine or making changes to medicines you take. It might involve psychological counseling or addressing alcohol or illicit drug use. […] Counseling can help by dealing with mental health problems linked to delayed ejaculation, such as depression or anxiety. […] Talk openly with your partner about your condition. Treatment often is more successful if couples work together as a team. You might want to see a counselor with your partner. This can help you address concerns you both might have about delayed ejaculation.

• #26 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  In spite of the lack of information regarding delayed ejaculation, the most successful approach, for sex therapists, is to engage both members of the couple into addressing the problem. Thus, ejaculatory dysfunction is always perceived as a couples issue. Resolving the problem is most successful when both partners can work together as a team toward a successful solution. […] Ejaculatory problems can have a devastating affect on self-esteem. Men with ejaculation problems undoubtedly have feelings of inadequacy, feelings of failure and a negative view of themselves. […] Ejaculation problems may also contribute to a low libido and lack of interest in sexual activity. Without ejaculation, sex can become a source of frustration and devoid of satisfaction. […] For some men, there may be additional psychological issues that underlie an ejaculatory dysfunction.

• #27 Delayed Ejaculation Treatment & Management: Pharmacotherapy, Psychological Interventions

  https://emedicine.medscape.com/article/2184956-treatment

  When pharmacotherapy for delayed ejaculation (DE) is under consideration, it is important to eliminate iatrogenic causes, including medications (eg, alpha-adrenergic blockers, other antihypertensives, antidepressants, and antipsychotics). […] Adjunctive therapies should be considered. Alpha sympathomimetics (eg, ephedrine or a combination of chlorpheniramine maleate and phenylpropanolamine hydrochloride [withdrawn from the US market]) have been used successfully in patients with retrograde ejaculation. […] Sildenafil and imipramine appear to be effective in psychotropic-induced male orgasmic disorder (MOD). […] Any psychological intervention must address both historical factors and current factors that might contribute to the present dysfunction. […] Counseling should be provided for patients who have normal wet dreams but cannot achieve orgasm and ejaculation during sexual activity. […] In addition to psychotherapy, anecdotal reports suggest that an electrovibrator applied at the lower surface of the glans penis can be an effective intervention in cases of primary male anorgasmia.

• #28 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression. […] Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis.

• #29

  https://111.wales.nhs.uk/encyclopaedia/e/article/ejaculationproblems/

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression. […] Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis.

• #30 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Clinicians should consider referring men diagnosed with lifelong or acquired delayed ejaculation to a mental health professional with expertise in sexual health. (Expert Opinion) […] Clinicians should advise men with delayed ejaculation that modifying sexual positions or practices to increase arousal may be of benefit. (Expert Opinion) […] Clinicians should suggest replacement, dose adjustment, or staged cessation of medications that may contribute to delayed ejaculation. (Clinical Principle) […] Clinicians should inform patients that there is insufficient evidence to assess the risk-benefit ratio of oral pharmacotherapy for the management of delayed ejaculation. (Expert Opinion) […] Clinicians may offer treatment to normalize serum testosterone levels in patients with delayed ejaculation and testosterone deficiency. (Expert Opinion)

• #31 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #32

  https://111.wales.nhs.uk/encyclopaedia/e/article/ejaculationproblems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #33 The drug treatment of delayed ejaculation – Abdel-Hamid – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/10477/html

  A variety of drugs are identified for potential use in this condition. […] In a recent survey to evaluate the current opinion and clinical management of DE by members of the Sexual Medicine Society of North America (SMSNA), cabergoline and bupropion were the most commonly selected first line treatments for DE. […] The choice of management option should be guided by the etiologic factor, illness characteristics (DE or anejaculation), patient preferences, and physicians comfort with different. […] To conclude, successful drug treatment of DE is still in its infancy. […] The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care to the patients.

• #34 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #35 Delayed ejaculation – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/diagnosis-treatment/drc-20371363

  A physical exam and medical history might be all that are needed to suggest treatment for delayed ejaculation. […] Delayed ejaculation treatment depends on the cause. Treatment might include taking medicine or making changes to medicines you take. It might involve psychological counseling or addressing alcohol or illicit drug use. […] Counseling can help by dealing with mental health problems linked to delayed ejaculation, such as depression or anxiety. […] Talk openly with your partner about your condition. Treatment often is more successful if couples work together as a team. You might want to see a counselor with your partner. This can help you address concerns you both might have about delayed ejaculation.

• #36 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Clinicians should consider referring men diagnosed with lifelong or acquired delayed ejaculation to a mental health professional with expertise in sexual health. (Expert Opinion) […] Clinicians should advise men with delayed ejaculation that modifying sexual positions or practices to increase arousal may be of benefit. (Expert Opinion) […] Clinicians should suggest replacement, dose adjustment, or staged cessation of medications that may contribute to delayed ejaculation. (Clinical Principle) […] Clinicians should inform patients that there is insufficient evidence to assess the risk-benefit ratio of oral pharmacotherapy for the management of delayed ejaculation. (Expert Opinion) […] Clinicians may offer treatment to normalize serum testosterone levels in patients with delayed ejaculation and testosterone deficiency. (Expert Opinion)

• #37 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #38

  https://111.wales.nhs.uk/encyclopaedia/e/article/ejaculationproblems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #39 Ejaculation problems

  https://www.nhs.uk/conditions/ejaculation-problems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #40

  https://111.wales.nhs.uk/encyclopaedia/e/article/ejaculationproblems/

  Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex and help make ejaculation easier. […] Some integrated care boards (ICBs) provide a sex therapy service on the NHS. Availability can vary widely depending on where you live. […] There are a number of medicines that can be used if it’s thought SSRIs are responsible for causing delayed ejaculation. These include: amantadine originally designed to treat viral infections, bupropion usually prescribed to help people quit smoking, yohimbine originally designed to treat erectile dysfunction. […] Alcohol misuse and recreational drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. […] Pseudoephedrine tablets may be tried, but these will need to be prescribed „off-label”. This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use (pseudoephedrine is normally used as a decongestant).

• #41 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can be prevented. […] Drinking alcohol in moderation can help reduce your chances of having delayed ejaculation. […] It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

• #42 Delayed ejaculation – treatment, causes and diagnosis | healthdirect

  https://www.healthdirect.gov.au/delayed-ejaculation

  Delayed ejaculation is when you have trouble reaching orgasm and ejaculating. […] Treatment depends on the cause. […] You should talk to your doctor if you have delayed ejaculation and it is bothering you. […] Can delayed ejaculation be prevented? […] Delayed ejaculation can’t be prevented if the cause is physical, such as nerve damage. But you can avoid things that might make delayed ejaculation worse, such as alcohol and recreational drugs.

• #43 Delayed ejaculation: Causes & treatment | Healthy Male

  https://healthymale.org.au/mens-health/delayed-ejaculation

  Delayed ejaculation is the term commonly used for conditions that result in men experiencing difficulties with reaching orgasm and ejaculating. […] Delayed ejaculation is more likely to occur if you have particular health conditions or take specific types of medicines. […] Antidepressants and medications to help control blood pressure are among the drugs that may delay ejaculation. […] The more medical problems you have, the more likely you are to have delayed ejaculation. Stress and being tired also increase your chance of delayed ejaculation. […] There are a variety of medications that can be used to treat delayed ejaculation, but vibratory stimulation of the penis and counselling are usually effective. […] If the cause of your delayed ejaculation is psychological, then speaking to someone like a sexual health therapist can help. […] Delayed ejaculation can be successfully treated but, because its such a complex problem, its difficult to know how long it might take and exactly how successful your treatment will be.

• #44 Premature Ejaculation (PE): Causes, Symptoms, Prevention and Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/understanding-premature-ejaculation-causes-treatment-prevention

  How to prevent early ejaculation can be a very daunting question in your mind. But the good news is premature ejaculation can be delayed. Here are some tips for you: […] Incorporate pelvic floor exercises in your daily routine to strengthen your pelvic muscles and have better control of ejaculation. Identify the muscle you would use to stop urinating midstream, then squeeze and release. Begin with a few seconds, increasing gradually. Aim for 10 contractions. […] Maintain a stress-free lifestyle to prevent early ejaculation. […] If external help is required, reach out to a psychological counsellor and a urologist; together, they can help rectify your issues.

• #45 Premature Ejaculation — Urology Care Wellington

  https://www.urologycarewellington.co.nz/premature-ejaculation

  In many instances premature ejaculation gets better on its own given some time. Practicing of relaxation techniques or utilizing distraction methods may assist in delaying ejaculation, as can learning to identify and control sensations that precede ejaculation. […] Techniques such as those listed below may assist also: […] Utilizing a condom to reduce sensation […] Trialing of different sexual positions. […] This is a form of meditation that can assist in controlling the arousal and tension buildup which often leads to early ejaculation. […] The technique aborts the ejaculation reflex and delays orgasm. The goal is to teach yourself to become aware of the sensations leading up to orgasm, and then begin to control and delay on your own. […] If you have strong pelvic floor muscles then they can assist you to delay orgasm.

• #46 Delayed ejaculation: Causes & treatment | Healthy Male

  https://healthymale.org.au/mens-health/delayed-ejaculation

  Delayed ejaculation is the term commonly used for conditions that result in men experiencing difficulties with reaching orgasm and ejaculating. […] Delayed ejaculation is more likely to occur if you have particular health conditions or take specific types of medicines. […] Antidepressants and medications to help control blood pressure are among the drugs that may delay ejaculation. […] The more medical problems you have, the more likely you are to have delayed ejaculation. Stress and being tired also increase your chance of delayed ejaculation. […] There are a variety of medications that can be used to treat delayed ejaculation, but vibratory stimulation of the penis and counselling are usually effective. […] If the cause of your delayed ejaculation is psychological, then speaking to someone like a sexual health therapist can help. […] Delayed ejaculation can be successfully treated but, because its such a complex problem, its difficult to know how long it might take and exactly how successful your treatment will be.

• #47

  https://111.wales.nhs.uk/encyclopaedia/e/article/ejaculationproblems/

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] You may have delayed ejaculation if you’re unable to ejaculate more than half the times you have sex. […] Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. […] Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation for example, relationship problems, stress or depression. […] Physical causes of delayed ejaculation include: diabetes, spinal cord injuries, multiple sclerosis, surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), medicines to treat high blood pressure, such as beta-blockers, antipsychotics, used to treat episodes of psychosis.

• #48 Ejaculation problems | nidirect

  https://www.nidirect.gov.uk/conditions/ejaculation-problems

  Delayed ejaculation (male orgasmic disorder) is classed as either: […] Delayed ejaculation can also be caused by psychological and physical factors. […] Physical causes of delayed ejaculation include: diabetes (usually only type 1 diabetes), spinal cord injuries, multiple sclerosis (MS), surgery to the bladder or prostate gland, increasing age. […] Many medicines are known to cause delayed ejaculation, including: antidepressants, particularly SSRIs, medications to treat high blood pressure, such as beta-blockers, antipsychotics, muscle relaxants, powerful painkillers. […] Delayed ejaculation can suddenly start to happen after previously having no problems, or the man may have always experienced it. […] It may occur in all sexual situations or only in certain situations, such as during sex but not during masturbation.

• #49 Delayed ejaculation: Causes & treatment | Healthy Male

  https://healthymale.org.au/mens-health/delayed-ejaculation

  Delayed ejaculation is the term commonly used for conditions that result in men experiencing difficulties with reaching orgasm and ejaculating. […] Delayed ejaculation is more likely to occur if you have particular health conditions or take specific types of medicines. […] Antidepressants and medications to help control blood pressure are among the drugs that may delay ejaculation. […] The more medical problems you have, the more likely you are to have delayed ejaculation. Stress and being tired also increase your chance of delayed ejaculation. […] There are a variety of medications that can be used to treat delayed ejaculation, but vibratory stimulation of the penis and counselling are usually effective. […] If the cause of your delayed ejaculation is psychological, then speaking to someone like a sexual health therapist can help. […] Delayed ejaculation can be successfully treated but, because its such a complex problem, its difficult to know how long it might take and exactly how successful your treatment will be.

• #50 Ejaculation Problems: Too Fast, Too Slow or Not at All? » Sexual Medicine » BUMC

  https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/

  Traditional behavioral sex therapy for delayed ejaculation is as follows: the man begins by masturbating, then starts intercourse when he is almost ready to ejaculate; the procedure continues with the man beginning intercourse earlier and earlier. […] Delayed ejaculation carries with it issues of inability to achieve orgasm and infertility. Anti-depressants or agents which act centrally such as Valium, anti-hypertensives and alcohol abuse all can affect this. […] A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. If the delayed ejaculation is situational is is probably psychologic; if it is generalized the problem is probably biologic.

• #51 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  Identifying and seeking treatment for DE sometimes exposes an underlying medical condition. […] Once this is treated, DE often resolves. […] Treatment or counseling can help resolve these issues. […] By facilitating open, honest communication, understanding can often be reached. […] There are many possible causes of DE. […] Regardless of the cause, treatments are available. […] By asking for help, you can get the psychological and physical support needed to address the issue and enjoy a more fulfilling sex life.

• #52 Delayed ejaculation – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/delayed-ejaculation/symptoms-causes/syc-20371358

  Delayed ejaculation can be a brief or lifelong problem. Possible causes of delayed ejaculation include certain ongoing health conditions, surgeries and medicines. Treatment for delayed ejaculation depends on the cause. […] Some medicines, certain ongoing health conditions and surgeries can cause delayed ejaculation. Other causes include substance misuse or a mental health concern, such as depression, anxiety or stress. Often, it’s due to a mix of physical and psychological concerns. […] Your main healthcare professional is a good place to start when you have delayed ejaculation. See your healthcare professional if: Delayed ejaculation is an issue for you or your partner. You have another health problem that might be linked to delayed ejaculation. Or you take medicines that could cause delayed ejaculation.

• #53 Disorders of Ejaculation: An AUA/SMSNA Guideline (2020) – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/disorders-of-ejaculation

  Lifelong delayed ejaculation is defined as lifelong, consistent, bothersome inability to achieve ejaculation, or excessive latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. (Expert Opinion) […] Acquired delayed ejaculation is defined as an acquired, consistent, bothersome inability to achieve ejaculation, or an increased latency of ejaculation, despite adequate sexual stimulation and the desire to ejaculate. (Expert Opinion) […] Clinicians should assess medical, relationship, and sexual history and perform a focused physical exam to evaluate a patient with delayed ejaculation. (Clinical Principle) […] Clinicians may utilize additional testing as clinically indicated for the evaluation of delayed ejaculation. (Conditional Recommendation; Evidence Level: Grade C)

• #54 Delayed Ejaculation: Pathophysiology, Diagnosis, and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5756804/

  The history is the key to the diagnosis. […] Defining firm recommendations to approach the treatment of DE/AE is difficult for a condition that is less common and heterogeneous, for which the literature is confined to case reports, case series, and small studies. […] A rigid treatment plan is not suitable for all patients.

• #55 Delayed Ejaculation: Symptoms, Causes, and Treatment

  https://psychcentral.com/health/delayed-ejaculation

  The inability to ejaculate or taking a long time to ejaculate is a sexual dysfunction that can cause distress. Finding treatment can help alleviate symptoms and improve overall well-being. […] You can find treatment for this condition and regain a satisfying sex life. […] If you have delayed ejaculation, it may be helpful to talk with a medical professional to assess your options for treatment. […] Treatment doesn’t have to be shameful; it can help you alleviate symptoms leading to an unsatisfying sex life. […] Treating delayed ejaculation is dependent on what is causing the condition. […] Additionally, research indicates another treatment option is the Sexual Tipping Point (STP) Model for treatment of delayed ejaculation. […] Another aspect of the treatment of delayed ejaculation for many individuals is to treat any medical conditions that can cause sexual dysfunction.

• #56 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can be prevented. […] Drinking alcohol in moderation can help reduce your chances of having delayed ejaculation. […] It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

• #57 Premature Ejaculation (PE): Causes, Symptoms, Prevention and Treatment

  https://www.metropolisindia.com/blog/preventive-healthcare/understanding-premature-ejaculation-causes-treatment-prevention

  How to prevent early ejaculation can be a very daunting question in your mind. But the good news is premature ejaculation can be delayed. Here are some tips for you: […] Incorporate pelvic floor exercises in your daily routine to strengthen your pelvic muscles and have better control of ejaculation. Identify the muscle you would use to stop urinating midstream, then squeeze and release. Begin with a few seconds, increasing gradually. Aim for 10 contractions. […] Maintain a stress-free lifestyle to prevent early ejaculation. […] If external help is required, reach out to a psychological counsellor and a urologist; together, they can help rectify your issues.

• #58 Delayed Ejaculation: Causes, Symptoms, & Diagnosis

  https://www.healthline.com/health/delayed-ejaculation

  Identifying and seeking treatment for DE sometimes exposes an underlying medical condition. […] Once this is treated, DE often resolves. […] Treatment or counseling can help resolve these issues. […] By facilitating open, honest communication, understanding can often be reached. […] There are many possible causes of DE. […] Regardless of the cause, treatments are available. […] By asking for help, you can get the psychological and physical support needed to address the issue and enjoy a more fulfilling sex life.

• #59

  https://link.springer.com/article/10.1007/s11930-020-00287-z

  Delayed ejaculation (DE), although relatively rare, can be a disconcerting and challenging disorder for patients to live with and physicians to treat. […] In this review, the psychosocial and infertility factors related to DE are covered briefly, and the current pharmacologic agents used to treat DE are reviewed. […] Some drug treatments for DE have potential, although many require further research. […] A holistic approach is necessary for the patient with DE, including careful consideration of the psychosocial factors related to DE. […] Many of the reviewed drugs for DE have been used for the treatment of DE arising from various potential etiologies (such as antidepressant-induced DE, hypogonadism, hyperprolactinemia, etc.). […] Ultimately, the etiology of DE in each patient must be carefully considered and treatment must be individualized.

• #60 Delayed Ejaculation: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22125-delayed-ejaculation

  Delayed ejaculation can be prevented. […] Drinking alcohol in moderation can help reduce your chances of having delayed ejaculation. […] It’s also important to have an open, honest relationship with your partner. Improving your communication may help prevent delayed ejaculation from developing or getting worse.

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